Provider Demographics
NPI:1548346760
Name:SAWYER LYONS, LORI LYNN (PSYD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:LYNN
Last Name:SAWYER LYONS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 EMBASSY DRIVE SOUTH
Mailing Address - Street 2:SUITE 3
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4573
Mailing Address - Country:US
Mailing Address - Phone:954-436-3800
Mailing Address - Fax:954-436-3700
Practice Address - Street 1:2525 EMBASSY DRIVE SOUTH
Practice Address - Street 2:SUITE 3
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33026-4573
Practice Address - Country:US
Practice Address - Phone:954-436-3800
Practice Address - Fax:954-436-3700
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6309103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54658OtherBLUE CROSS BLUE SHIELD
FL54658OtherBLUE CROSS BLUE SHIELD